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目的研究重症急性胰腺炎(SAP)心肌功能损害时心肌核因子-κB(NF-κB)的活化及葡激酶的干预作用。方法63只SD大鼠随机分为假手术组(n=9)、ANP组(n=27)、葡激酶干预组(n= 27),ANP模型采用5％的牛磺胆酸钠胰胆管逆行注射方法建立。干预自造模前2 d腹腔注射葡激酶1．5 mg／kg体重,一天2次,共4次。ELISA法测定制模后6 h、12 h、24 h各时点血TNF-α、IL-6含量;RT- PCR检测心肌NF-κB mRNA的表达;免疫组化法检测心肌NF-κB蛋白的表达,常规观察胰腺及心肌组织的病理变化。结果ANP组术后6 h大鼠心肌NF-κB mRNA及NF-κB蛋白表达异常增高,TNF-α、IL-6呈进行性升高,干预组胰腺及心肌组织的病理变化减轻。心肌NF-κB mRNA及蛋白表达下词,血TNF-α、IL-6明显下降,与ANP组比较,差异均显著(P<0．05)。结论ANP大鼠的心肌损伤可能与循环中TNF-α、IL-6水平升高导致的心肌NF-κB活化有关。葡激酶对SAP并发的心肌损伤具有防治作用。
Objective To study the activation of myocardial nuclear factor-κB (NF-κB) and the intervention of staphylokinase in myocardial injury of severe acute pancreatitis (SAP). Methods Sixty-three SD rats were randomly divided into sham operation group (n = 9), ANP group (n = 27) and staphylokinase intervention group (n = 27). ANP model was retrospectively treated with 5% sodium taurocholate and pancreaticobiliary duct Injection method established. Intervention 2d before intraperitoneal injection of staphylokinase 1.5 mg / kg body weight, 2 times a day, a total of 4 times. The levels of TNF-α and IL-6 in blood at 6 h, 12 h and 24 h after model establishment were measured by ELISA. The expression of NF-κB mRNA in myocardium was detected by RT-PCR and the expression of NF-κB Expression, routine observation of pancreatic and myocardial tissue pathological changes. Results The expression of NF-κB mRNA and NF-κB protein in the myocardium of ANP group increased significantly at 6 h after operation, and the levels of TNF-α and IL-6 in the ANP group increased progressively. The pathological changes of pancreas and myocardium in the intervention group were alleviated. The expressions of NF-κB mRNA and protein, TNF-α and IL-6 in myocardium were significantly lower than those in ANP group (P <0.05). Conclusion Myocardial injury in ANP rats may be related to the activation of NF-κB induced by elevated levels of TNF-α and IL-6 in circulation. Stapulokinase has a preventive and therapeutic effect on SAP complicated with myocardial injury.